Lisinopril and Dexibuprofen: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lisinopril
Dexibuprofen
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Lisinopril is a blood pressure medicine, and dexibuprofen is an anti-inflammatory pain reliever (an NSAID, similar to ibuprofen). When taken together, the NSAID can make lisinopril work less well, so your blood pressure may not stay as low as it should. Both drugs also affect your kidneys, and using them together can put extra stress on them, especially if you are older, dehydrated, or already have kidney trouble.
The good news is this is very manageable. Keep taking both exactly as prescribed, drink enough fluids, and let your care team check your blood pressure and kidneys. Ask your pharmacist or doctor if you are unsure.
Effect: NSAID (dexibuprofen) may blunt the antihypertensive and natriuretic effect of the ACE inhibitor (lisinopril), and additive renal effects can cause deterioration of renal function, including possible acute renal failure.
Mechanism: NSAID inhibition of renal prostaglandin synthesis reduces afferent arteriolar vasodilation; combined with ACEi efferent effects this compromises glomerular perfusion and sodium handling. Neither agent is metabolically activated in a way that alters direction.
Evidence: Established. Severity: moderate. Onset: unspecified.
- Monitor blood pressure for loss of efficacy.
- Assess renal function at initiation and periodically.
- Highest risk: elderly, volume-depleted, preexisting renal dysfunction.
- Ensure adequate hydration.
What happens
Reduced antihypertensive effect and renal dysfunction and/or increased blood pressure
Interaction Deep Dive
The blood pressure lowering and natriuretic actions of ACE inhibitors or angiotensin receptor blockers (ARBs) may be reduced by NSAIDs. Taking these agents together can also worsen renal function in certain patients, with acute renal failure being a possibility. If the combination cannot be avoided, evaluate whether renal function monitoring is warranted when therapy begins, watch for adequate antihypertensive response, and periodically check renal function for indications of decline or failure. This is particularly important for elderly patients, at the start of treatment, in those who are volume-depleted, and in individuals with existing renal impairment. Confirm that patients maintain adequate hydration1234.
Why it happens (mechanism)
Additive effects on renal function; decreased renal prostaglandin production
How to manage this interaction
This combination can usually be handled safely with monitoring. Here is what a care team typically does and what you can do:
- Keep taking both medicines as prescribed unless your prescriber tells you otherwise.
- Your team may check your blood pressure to make sure the lisinopril is still working well.
- They may check your kidney function when treatment starts and periodically after that.
- Stay well hydrated, since dehydration raises the risk.
Tell your pharmacist or doctor if you are elderly, have kidney problems, or notice less urine, swelling, or rising blood pressure. Ask before adding any other over-the-counter pain reliever.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) A 48-year-old man with hypertension that had previously been well managed on enalapril 10 mg/day developed severe hypertension, psychosis, disorientation, and generalized anasarca four days after starting indomethacin 100 mg/day for gout 5. Raising the enalapril dose to 20 mg/day did not bring the hypertension under control, so indomethacin was stopped. Within one day, the patient underwent rapid diuresis and lost a considerable amount of weight. The enalapril dose was subsequently lowered back to 10 mg/day, achieving good hypertension control with no lingering psychosis 6.
b) In a randomized, double-blind, parallel-design multicenter study of 141 hypertensive patients, indomethacin counteracted the antihypertensive action of captopril. After one week of taking indomethacin and captopril together, 24-hour systolic blood pressure rose by 4.6 mmHg and diastolic by 2.7 mmHg (p less than 0.001). Across the study, ambulatory diastolic blood pressure increased in 67% of patients on captopril during indomethacin therapy 7.
c) A 59-year-old man who had been treated with lisinopril 10 mg/day for 5 years experienced worsening hypertension after rofecoxib 25/day was started for arthritic pain. Over 5 weeks, blood pressure rose from 130 to 135/80 to 85 to 168/98. Rofecoxib was stopped. Blood pressure fell over the next 18 days (averaging 127/78 mmHg). Because of increased joint pain, rofecoxib was resumed at 25 mg/day. After 2 days on therapy, blood pressure went up, and over the following 2 weeks it averaged 143/89 mmHg. Lisinopril was raised to 20 mg/day, producing an average blood pressure of 121/81 mmHg over the subsequent 21 days 8.
d) In a double-blind, placebo-controlled, parallel-group trial of 178 hypertensive patients, celecoxib did not diminish the antihypertensive effect of lisinopril. In addition to their usual lisinopril regimen (10 to 40 mg daily), patients took celecoxib 200 mg twice daily or placebo for 4 weeks. Changes from baseline in 24-hour systolic and diastolic blood pressure (BP) were not significant. The fraction of patients whose 24-hour BP rose by at least 5, 10, 15, or 20 mmHg was likewise comparable between celecoxib and placebo. The placebo-subtracted 24-hour BP changes observed (1.6/1.2 mmHg) were smaller than those reported for NSAIDs in patients treated with ACE inhibitors 9.
Common questions
Can I take Lisinopril and Dexibuprofen together?
Dexibuprofen can weaken lisinopril's blood-pressure control and add strain on your kidneys, so stay hydrated and let your care team monitor your blood pressure and kidney function while you take both. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Dexibuprofen interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Lisinopril and Dexibuprofen interaction managed?
This combination can usually be handled safely with monitoring. Here is what a care team typically does and what you can do: Keep taking both medicines as prescribed unless your prescriber tells you otherwise. Your team may check your blood pressure to make sure the lisinopril is still working well. They may check your kidney function when treatment starts and periodically after that. Stay well hy… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Lisinopril or Dexibuprofen need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (9)
- Product Information: Dynastat intravenous injection, intramuscular injection, parecoxib sodium intravenous injection, intramuscular injection. Pfizer Australia Pty Ltd (per Australian Register of Therapeutic Goods), West Ryde, Australia, 2017. DailyMed
- Product Information: SPRIX(R) nasal spray, ketorolac tromethamine nasal spray. Egalet US Inc. (per FDA), Wayne, PA, 2016. DailyMed
- Product Information: CALDOLOR(R) intravenous injection, ibuprofen intravenous injection. Cumberland Pharmaceuticals Inc. (per FDA), Nashville, TN, 2016. DailyMed
- Product Information: meloxicam oral tablets, meloxicam oral tablets. Apotex Corp. (per DailyMed), Weston, FL, 2016. DailyMed
- Ahmad S: Indomethacin-enalapril interaction: an alert (letter). South Med J 1991; 84:411-412. PubMed
- Morgan T, Anderson A, & Bertram D: Effect of indomethacin on blood pressure in elderly people with essential hypertension well controlled on amlodipine or enalapril. Am J Hypertens 2000; 13:1161-1167. PubMed
- Conlin P, Moore T, Swartz S, et al: Effect of indomethacin on blood pressure lowering by captopril and losartan in hypertensive patients. Hypertension 2000; 36:461-465. PubMed
- Brown C: Effect of rofecoxib on the antihypertensive activity of lisinopril (letter). Ann Pharmacother 2000; 34:1486. PubMed
- White W, Kent J, Taylor A, et al: Effects of celecoxib on ambulatory blood pressure in hypertensive patients on ACE inhibitors. Hypertension 2002; 39:929-934. PubMed
Keep reading about Lisinopril
Keep reading about Dexibuprofen
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